Breanna Rose Shockman

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

9324 Issued in MN

Practice address

610 30TH Ave W
Alexandria, MN 56308-3426

Phone

(320) 763-5123

NPI assigned

Jul 21, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Alomere HealthGroup PAC ID 9931690047, 123 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Alomere Health Hospital, Alexandria, MN, CCN 240030

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: bshockman631318@direct.centracare.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alomere Health

  • General Acute Care Hospital
  • Alexandria, MN
  • NPI 1558236091
  Medicare reassignment Care Compare group NPD
• Alexandria Clinic PA

  • Multi-Specialty Clinic/Center
  • Alexandria, MN
  • NPI 1346211315
  NPD
• Alomere Health

  • Durable Medical Equipment & Medical Supplies
  • Willmar, MN
  • NPI 1467318246
  NPD
• Douglas County Hospital

  • General Acute Care Hospital
  • Alexandria, MN
  • NPI 1164424305
  NPD
• West Central Pathology and Laboratory Medicine PA

  • Clinical Medical Laboratory
  • Alexandria, MN
  • NPI 1811988025
  NPD
• Douglas County Hospital

  • Orthopaedic Surgery Physician
  • Alexandria, MN
  • NPI 1427342138
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Alomere Health

  • General Acute Care Hospital
  • Alexandria, MN
  • NPI 1558236091
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1658361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729468800000",
    "number": "1962137141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 30TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 30TH AVE W",
            "city": "ALEXANDRIA",
            "state": "MN",
            "postal_code": "563083426",
            "telephone_number": "320-763-5123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKMAN",
        "first_name": "BREANNA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-21",
        "last_updated": "2024-10-21",
        "certification_date": "2024-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2450603",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MN",
            "license": "9324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RN LICENSE",
            "identifier": "2450603",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sharon'S Senior Services Inc
• Sharons Senior Services Inc
• Jody J. Shaskey-Setright, MS, LICSW
• Jamie Lyn Shelley, CNM
• Sherie Carlson PHD LP PLLC
• Lindsey Sholts
• Shoptikal LLC
• Tricia Jean Shoutz, NP-C
• Christopher Leigh Siegel, ATC, CSCS, EMT
• Destiny Sieracki

• Family Nurse Practitioner in Alexandria, MN
• Providers in Alexandria, MN by specialty
• Family Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.